Understanding the Connection Between Eating Disorders and Substance Use in Recovery

When someone is in recovery from substance use, it’s common for other issues to surface, including disordered eating behaviors and eating disorders. These problems are often linked, with many people struggling with both substance use and eating issues at the same time. This blog post will dive into the relationship between eating pathology (such as binge eating, purging, and unhealthy dieting) and substance use, as well as how people in recovery can manage these challenges.

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The Link Between Eating Disorders and Substance Use

Eating pathology refers to a range of behaviors that are common in eating disorders, like binge eating, purging (vomiting or using laxatives), or extreme dieting. Studies show that up to 50% of people with eating disorders also use alcohol or drugs, which is five times higher than the general population. On the flip side, around 35% of people who are dependent on substances like alcohol or drugs have also struggled with eating disorders, which is 11 times higher than the general population.

When these issues occur together, it’s often hard to tell which one started first. For some, unhealthy eating behaviors may resurface or worsen during recovery from substance use. This is why it’s important to consider and address both eating disorders and substance use simultaneously.

Changes in Appetite During Recovery

When someone stops using drugs or alcohol, their body goes through a lot of changes. One of these changes involves the way hunger cues work. During active substance use, people’s ability to recognize hunger and fullness can be impaired, and once they stop using, their appetite can become irregular. This often leads to overeating or unhealthy eating patterns, which can result in unwanted weight gain.

In recovery, the body may also crave comfort foods, particularly sugary snacks, as a way to cope with emotional pain. Just like substance use can trigger cravings, food can also become a way to self-medicate, leading to episodes of binge eating.

The Impact of Substance Use on Women in Recovery

For women, especially those who have used stimulants like methamphetamines or cocaine, recovery can be a vulnerable time. Many women feel a strong desire to maintain a thin, idealized body, and this can drive them to develop more extreme eating behaviors. If they experience weight gain during recovery, this frustration can lead to a return to substance use or more unhealthy eating practices.

Recognizing Disordered Eating Symptoms

If you or someone you know is struggling with disordered eating, it’s important to recognize the symptoms. These might include:

Compensatory behaviors like purging, fasting, over-exercising, or misusing laxatives to counteract eating.
Notable changes in eating patterns, such as under-eating or overeating.
Cutting out certain foods for non-medical reasons, like avoiding carbs or fats.
Eating during the night or having trouble controlling eating habits.
Repeatedly discussing things like fad diets, diet pills, or obsessive thoughts around food and “clean” eating.
Extreme focus on weight, including frequent scale checking, or constantly comparing one’s body to others.
Extreme weight loss or cycles of gaining and losing weight
A heightened focus on appearance, like checking mirrors obsessively or comparing oneself on social media.

How to Support Someone in Recovery

If you’re a professional, family member, or friend supporting someone in recovery, it’s important to communicate in a way that helps them build a healthier relationship with food and their body. Disordered eating is often influenced by societal pressures to conform to an ideal body shape, so language can make a big difference.

Here are some suggestions for supporting those in recovery:

Validate weight concerns without encouraging weight loss or focusing on appearance.
Use empathy and positive language instead of shaming or criticizing.
Avoid triggering language related to dieting or food restrictions. For example, don’t use phrases like “bad food” or “portion control.” Instead, focus on having reasonable amounts and enjoying a variety of foods.
Discourage frequent weighing or obsessing over weight. Ideally, weigh less than once a week, or not at all.
Encourage balanced meals that include a variety of nutrient-rich foods.
Promote mindful and intuitive eating, helping individuals reconnect with their body’s natural hunger and fullness cues.
Support boundaries by helping individuals develop a healthy relationship with food, physical activity, and their body. Unlike many other addictions, we can’t quit food, so it’s about learning how to develop balance and moderation.

What You Can Do for Yourself in Recovery: Managing Eating Disorders

If you’re in recovery from substance use and struggling with disordered eating or body dissatisfaction, it’s important to remember that you’re not alone, and healing is possible. Recovery is a journey, and just as you work on healing from substance use, you can also take steps to improve your relationship with food and your body. Here are some practical things you can do for yourself:

1. Reconnect with Your Body’s Hunger Cues

One of the first steps in managing eating disorders during recovery is reconnecting with your body’s natural hunger and fullness signals. After substance use, your body’s ability to recognize these cues may be out of sync, but with time and patience, you can relearn them. Pay attention to your body when you feel hungry or full, and try to eat meals without judgment or guilt.

2. Practice Mindful Eating

Mindful eating involves paying full attention to the eating experience without distractions. This can help you focus on the taste, texture, and satisfaction of your food, allowing you to recognize when you’re full or satisfied. Mindful eating can also help reduce emotional eating and cravings by allowing you to address the emotional triggers that may lead to binge eating or unhealthy food choices. For some, eating mindfully can be challenging and may require additional guidance from a trusted healthcare provider.

3. Set Realistic Expectations for Your Body

During recovery, your body may go through changes, and it’s important to be kind to yourself. If you’re frustrated with weight gain or changes in your physical appearance, try to shift the focus away from numbers on a scale or appearance and toward how your body feels and functions. It may help to remind yourself that healing comes in many forms — and that includes mental, emotional, and physical healing.

4. Create Healthy Boundaries with Food

Just like substance use, disordered eating can feel addictive. It’s important to set boundaries with yourself around food. For example, try to avoid bingeing, purging, or other extreme behaviors. Focus on creating balanced meals with a variety of nutrients to nourish your body. Allow yourself to enjoy food without guilt, knowing that it’s okay to eat without restrictive rules or fears of weight gain.

5. Seek Support and Talk About Your Struggles

Recovery from both substance use and eating disorders is easier when you have support. Don’t hesitate to reach out to a therapist, support group, or trusted friend to talk about your feelings toward food and your body. Therapy options like cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) can be particularly helpful in addressing negative thought patterns and behaviors associated with eating disorders.

6. Focus on Self-Compassion and Healing

Recovery isn’t about being perfect — it’s about progress. Be gentle with yourself and give yourself credit for every small step you take toward healing. Celebrate moments where you’re able to nourish your body, practice self-care, and let go of harmful thought patterns. Remember that your value isn’t tied to your appearance, and healing your relationship with food and your body is just as important as healing from substance use.

7. Avoid Triggering Environments or People

Sometimes, social media, certain environments, or people in your life can trigger negative thoughts or unhealthy behaviors related to food or body image. Consider setting boundaries around these triggers, like unfollowing accounts that promote unrealistic body standards or avoiding conversations that center around dieting and weight loss. Surround yourself with people who uplift you and support your journey to healing.

8. Celebrate Non-Physical Achievements

Recovery is about more than just your physical appearance. Take time to celebrate accomplishments that aren’t related to weight, such as improved mental health, stronger relationships, or achieving recovery milestones. This can help shift your focus away from external appearance and toward what truly matters in your life.

To learn more about body dissatisfaction in recovery, read this blog post.

Final Thoughts

Recovery from substance use is already challenging, and when eating disorders or disordered eating behaviors are involved, it can feel even harder. However, with the right support and approach, it’s possible to address both issues at once and help individuals develop healthier eating habits and a positive body image.

If you or someone you know is struggling with eating pathology in recovery, it’s important to seek support from healthcare providers, registered dietitian nutritionists, and/or support groups that understand the connection between substance use and eating behaviors. By focusing on balance, empathy, and understanding, we can help those in recovery build a healthier, more sustainable relationship with food and their bodies.

Do you or someone you know struggle with an unhealthy relationship with food? Learn how to nourish your body and mind with our course on nutrition for substance use recovery click here. Discover practical tools and expert guidance to develop a healthy relationship with food, support your healing process, and build a strong foundation for lasting recovery.